This is a hard thing to admit, but easy to see, if you know me. While I am still 110 pounds lighter than I was in 2002, I am 60 pounds heavier than I was at my lowest in 2008, and that’s no accident. I ate myself that way, and today I am, in fact, still fat. Technically, with a Body Mass Index (BMI) of 37, I am considered obese. And even at my lowest weight (204 pounds), my BMI (28.5) was still at the high end of overweight! How did the weight regain happen? Well, I’ll tell you.
Before I do, though, I want you to know that I am, I think – and I think my doctor would agree – much, much healthier than I was in 2002. And I don’t mean just less fat. I have a much better and more stable blood sugar level, and I have been able to give up and stay off virtually all of the oral anti-diabetic medications I was taking back then. My Type 2 diabetes is still “in remission,” although my fasting blood sugars are usually “pre-diabetic” (>100mg/dl <126mg/dl), as are my A1c’s (high 5s). But my cholesterol profile has dramatically improved, with HDLs doubled and triglycerides cut by 2/3rds. See my popular blog posts # 281, #282 and #283 for a 35-year history with charts. And my hs CRP’s, chronic systemic inflammation markers, are very much improved (usually <1.0mg/dl, down from +/-6mg/dl). And – (drum roll) – my doctor took me off statins years ago.
And why is that? Why all the good news while I have re-gained 35% of my original weight loss? It is because I have fundamentally changed what I (usually) eat. I still follow a low-carb, high-fat (LCHF) Way of Eating most of the time. But I “cheat.” I’ll sometimes scarf down rolls (with butter) brought to the table in a restaurant. Sure, we could say, “no bread,” and sometimes we do, but at other times we don’t. I also raid the freezer at home occasionally to steal some of my wife’s ice cream. You see how easy it is to “blame” someone else for mytransgressions. At least I recognize the self-delusion.
It would also be easy to blame “habituation to rewarding neural dopamine signaling [that] develops with the chronic overconsumption of palatable foods, leading to a perceived reward deficit and compensatory increases in consumption.” For a good scientific roundup of why obesity is a vexing problem, see The Nutrition Debate #297: “Obesity in Remission.”
How things now stand: Because I eat LCHF, for the most part my Type 2 Diabetes continues to be in remission. But because I have lost a great deal of weight, I also have Obesity in Remission. As a consequence I need always to remember to “eat healthy” and at least 20% less than someone who has not previously been fat. “Elections have consequences,” and since I elected to eat carbs in excess and developed carbohydrate intolerance, I am foreverpredisposed to accumulate excess fat.
But 1) if I eat only the foods I have espoused and recognized as “good” for me, and 2) if I only eat when I am hungry, or alternatively just two small meals a day instead of the conventional three, I believe a) I would not have gained back any weight, and b) I might have continued to lose weight. After all, I probably shouldn’t weigh, at most, more than 175 pounds (BMI=24). But I did and I do, and so I confess it. Will that do me (or you, for that matter) any good? Well, the first step in making a change in your life is to acknowledge what you are doing that needs to change. And now I’ve done that.
So, we’ll see. I’m going to take a break now from writing this blog. I’ve written 305 posts over the last 4 years and 5 months. They have received altogether more than 150k page views, so it’s likely that someone (besides me) has benefitted from them. Readers who want to keep in touch, while I return to basics, can write to email@example.com. Or, visit the Bernstein Diabetes Forum, where I post from time to time and there’s lots of other friendly help and support and very good advice, especially for Type 2s and pre-diabetics who want to manage their condition with the aim of avoiding “the current treatment protocols (that) trap patients in a lifelong regimen of drug management, obesity and escalating diabetes.”
In taking leave of my readers I would be remiss if I didn’t heap praise on my editor. She has been a stalwart friend and helper throughout this period, always there with timely and helpful edits and links to scholarly resources. She is an inveterate professional, a tireless fact checker and my overall guiding support. And - no contest here – she always knew the subject better than I did. Thank you, thank you, and thank you, Laurie Weakley. (Too many “thank you’s,” Laurie?)